‘Dental tools cleaning’ lets down practices

on 30 November 2010

Twelve per cent of dental practices fail to meet ‘a satisfactory standard of decontamination’, a new government survey reveals.

The Dental National Decontamination Survey of almost 500 practices in England, overseen by the Department of Health (DH), found some practices falling short on cross-infection measures.

In total, 75 PCTs participated in the survey that involved nurses with training and experience in infection control visiting 487 randomly selected dental practices.

Overall, 71% of the dental practices visited were meeting essential quality requirements (EQR) to reduce the risk from re-usable dental instruments, with one in five meeting best practice guidelines.

Almost 20% more practices could reach this standard with small improvements to their technical performance, protocols and by better maintenance of decontamination equipment.

However, the survey found that the cleaning of dental instruments was one area where performance let them down.

The document reveals: ‘Decontamination in about 12% of practices was found to be unsatisfactory. The data indicates a wide range of often unrelated defects in practice, equipment and approach. These practices have a significant amount of work to do to achieve EQR by April 2011 at the latest when dental practices will come within the remit of the Care Quality Commission.

‘Further analysis on the deficiencies in this area and the support these practices can be given will be undertaken shortly.’

In a written statement to MPs, health minister Simon Burns says: ‘In recent years we have gained a better understanding of the risks of transmission of infectious diseases like hepatitis from poorly maintained health care premises and instruments which have not undergone effective decontamination.

‘The risk to individual dental patients is small but, with 1.5 million people undergoing dental treatment each week and some 500,000 people infected with blood borne viruses many of whom may be unaware of their infection, we cannot afford to be complacent.’

Practices were assessed in relation to essential quality requirements and best practice at the time HTM 01-05 was published.

Mr Burns explains: ‘The results of the survey showed that around 70% of practices were already working at EQR with some 20% of practices already achieving best practice. ‘Approaching 20% of practices were very near EQR with the remaining minority operating at an unsatisfactory standard. These results show that the majority of practices were meeting EQR and it is likely that this figure would have increased over the year as practices began to implement the HTM.’

He adds: ‘I was very encouraged to learn that well over two thirds of practices were already meeting EQR. As to the remainder, the survey data shows a number of practices need to improve their cleaning of instruments which is a critical part of the decontamination cycle.

‘The Department is encouraging practices to acquire automated washer-disinfectors, whose use is a feature of best practice, to achieve a uniformly high standard of cleaning of dental instruments.’

In the meantime, the DH and the Infection Prevention Society have jointly produced a self-assessment audit tool to allow all dental practices to assess their level of compliance with the quality standards in the guidance.

The Health Technical Memorandum (HTM) 01-05 on decontamination was published last November by the DH, setting out the various ways practices could meet the essential quality requirements.

All practices are expected to be operating at essential quality requirements (EQR) by the end of this year, but no timeframe has yet been set for the achievement of best practice due to current constraints imposed by the design and structure of some dental practice.